High-flow oxygen via tracheostomy improves oxygenation in patients weaning from mechanical ventilation: a randomised crossover study
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Weaning tracheostomised patients from prolonged mechanical ventilation (PMV) is challenging and at great financial cost. PMV is associated with significant morbidity and mortality which increases with the period of mechanical ventilation . Moreover, patients receiving PMV account for 6% of all ventilated patients but consume 37% of intensive care unit (ICU) resources .
High-flow nasal cannulae (HFNC) have demonstrated clinical benefits; however, these effects may not translate to high-flow tracheal oxygen (HFT) as mechanisms of action may differ between the two delivery modes. Limited evidence guides HFT use in clinical practice. Therefore, we undertook a randomised crossover study examining HFT’s effects on lung volumes [end-expiratory lung volume (EELV), tidal volume], airway pressure (Paw), oxygenation (SpO2/FiO2 ratio), ventilation [end-tidal carbon dioxide (etCO2)], respiratory rate (RR), heart rate and subjective dyspnoea compared with low-flow oxygen [T-piece (TP)].
KeywordsLung Volume Supplementary Material Table Prolonged Mechanical Ventilation Intensive Care Unit Length Randomise Crossover Study
This work was supported by a competitive grant from The Prince Charles Hospital Foundation Experienced Researcher grant. JFF would like to acknowledge his research fellowship from Queensland Health Office of Health and Medical Research.
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Conflicts of interest
JFF and AC have received assistance from Fisher and Paykel Healthcare Ltd to support travel and accommodation costs to attend research meetings. Fisher and Paykel Healthcare Ltd had no part in the current study. Other authors declare they have no conflicts of interest.